Effect of an Intensive Educational Program for Minority College Students and Recent Graduates on the Probability of Acceptance to Medical SchoolJoel C. Cantor, Sc.D.
Lois Bergeisen, M.A.
Laurence C. Baker, Ph.D.

Context: Increasing the number of minority physicians is a long-standing goal of professional associations and government.

Objective: To determine the effectiveness of an intensive summer educational program for minority college students and recent graduates on the probability of acceptance to medical school.

Design: Non-concurrent prospective cohort study based on data from medical school applications, MCATs, and the Association of American Medical Colleges Student and Applicant Information Management System.

Intervention: The Minority Medical Education Program (MMEP), a six-week, residential summer educational program focused on training in the sciences and improvement of writing, verbal reasoning, studying, test taking, and presentation skills.

Main Outcome Measure: Probability of acceptance to at least 1 medical school.

Results: In the 1997 medical school application cohort, 223 (49.3%) of 452 MMEP participants were accepted compared with 1406 (41.6%) of 3378 minority nonparticipants (p=.02). Positive and significant program effects were also found in the 1996 (p=.01) and 1992 (p=.005) cohorts and in multivariate analysis after adjusting for non-programmatic factors likely to influence acceptance (p<.001). Program effects were also observed in students who participated later and among those with relatively high as well as low grades and test scores.

Conclusions: The MMEP enhanced the probability of medical school acceptance among its participants. Intensive summer education is a strategy that may help improve diversity in the physician workforce. JAMA. 1998;280:772-776.

The educational debt of medical school graduates has been growing rapidly at a time when consumer credit is readily available to students and managed care is making significant changes in physician reimbursement. This combination of circumstances has given financial planning an increasingly important role in the lives of medical students. The more we understand about the financial practices and attitudes of our students before they come to medical school, the better we can target our financial advisement programs to address their needs during and after their enrollment. Previous studies have analyzed factors influencing medial student borrowing, the relationship between medical student debt and career choice, and how medical student attitudes toward educational debt and future income affect career choice. There have been studies, based on focus group interviews, of the financial attitudes, practices, and knowledge of students in general, but no study has attempted to analyze these elements for the medical student subset, which tends to be heavily indebted. The purpose of our study is to assess the financial practices, expectations, and knowledge of medical school applicants and to analyze them based on the demographic characteristics of sex and ethnicity differences.

In the eighteen years that I have been involved in dental education, I have seen student borrowing become a way of life. The average debt of a dental school graduate has increased from around $20,000 in 1982 to nearly $100,000 in 1999. Dental educators recognize that increasing student loan debt has the potential to impact dental education in many ways. Potential dental students must consider whether the cost of dental education is worth the financial investment and the acquisition of substantial debt. Dental school graduates must make practice decisions reflective of their potential ability to repay student loans. Dental educators are becoming increasingly concerned about the availability of dental health care to disadvantaged populations, and ethicists are considering how debt could compromise practice decisions of heavily indebted practitioners.

Higher education has entered the era of "pay as you go" consumerism. Meanwhile, the cost of dental education, and all higher education, continues to climb. Although the economy is strong and the dental applicant pool is relatively plentiful, are we setting ourselves up for a time when we cost ourselves out of business? Will only the wealthy be able to afford a dental education? Will dental health care become less widely available to disadvantaged populations?

A booming student loan industry has emerged as the outgrowth of federal legislation authorizing student financial aid. Student loans have become big business for many banks and lenders. Companies that employ thousands have been established to service student loans. University financial aid offices have grown and expanded their scope as they try to keep up with the explosion of federal regulations and the call for institutional accountability.

There is no specific career path to become a financial aid administrator. In fact, many of us fell into this business quite by accident. Further, the responsibilities of financial aid officers has grown from facilitating the process of applying for and receiving financial aid to that of financial planner and debt management specialist. As someone with one foot in the financial aid office and the other foot in the dental school admissions office, I offer this perspective. Journal of Dent Ed, 62 (5)

Successful careers are not planned. They develop when students are prepared for opportunities because they know their strengths, their method of work, and their values. — Norma Wagoner, Ph.D.

One of the most common challenges facing pre-health advisors is dealing with students who are not realistic about their own developing credentials and the competitive nature of gaining admission to health professions schools. Students are often unrealistic about their credentials, and often do not understand the complexity of issues which factor into the admissions process. Consider, for instance, the following statements:

– "If there is any chance that I can get in this year, then I have to try."

– "My uncle (the doctor) said he got a ‘C’ in organic chemistry and it didn’t hurt him getting into medical school."

– "I was told that all I need to get into medical school is good grades and MCATs."

– "I know that my grades and MCATs are low, but won’t my leadership positions and community volunteering make up for that?"

Do any of these statements sound familiar? What is our role in providing a reality check for students? Do we sometimes promote hope in students who are neither ready to apply nor realistic about their chances? How can we help our students realistically assess their application profile? How do we promote self-esteem and self-worth in a context of realism?

In this paper we outline an assessment instrument and a workshop titled "Assessing Your Application Profile" that we developed to address issues surrounding unrealistic self-assessment in our students. As health professions advisors, we believe our role is to empower our students to make informed decisions about their careers and to provide guidance, tools, and information which will enable them in this process.

Scholarship, Humanism, and the Young PhysicianRonald H. Fishbein, M.D.

It is time to understand the value of broad liberal education for those college students who aim to be physicians, both because the medical curriculum is becoming more humanistic (such a liberal education would support) and because three enormous challenges confront physicians and educators alike: the relentless tide of biomedical discoveries, the great financial burden that medical care imposes, and the public’s desperate plea for physicians who are more caring and communicative. A liberal education — meaning a course of study that is largely unrestricted and that attempts to sample the entire breadth of human knowledge — can help the premedical student cultivate, ripen, and enrich fundamental proficiencies such as accurate recording of observations, communicating ideas well, dealing with human emotions and becoming sensitive to human frailties, learning to listen and respond appropriately, learning to make sound judgments, and cultivating empathy and compassion. These are all skills that a liberal education can help the young student learn early rather than late, skills that prepare the student for dealing later with complex social, ethical and clinical issues as a physician.

A liberal education also can help prepare the student to take advantage of other general educational opportunities that are available in the small, closed community of residency, such a learning to both assume and delegate responsibility, to participate in rational debate while respecting the opinions of others, and to exercise mature judgment, civility, empathy and compassion.

While a liberal education will not necessarily make the student a more technically proficient doctor, for some it will be essential to awaken and sharpen those essential skills that a physician needs to rise to the top of a profession that never fails to recognize excellence and humanity. (Acad. Med. 1999;74:646-651)

Book Review: The Spirit Catches You and You Fall DownBook by Anne Fadiman
Review by Robert Cannon, Ph.D.